32 results on '"Frick AE"'
Search Results
2. Thorakale Messerstichverletzung und die Spätfolge - ein klinischer Fallbericht
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Frick, AE, Graff, M, Erne, B, Frese, S, Klemm, W, Rohlfing, H, Leschber, G, Frick, AE, Graff, M, Erne, B, Frese, S, Klemm, W, Rohlfing, H, and Leschber, G
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- 2015
3. Treatment and survival of patients with malignant pleural mesothelioma
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Frick, AE, Stubenberger, E, Posch, F, Jank, B, Müller, MR, Hochmair, M, and Watzka, SB
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ddc: 610 ,610 Medical sciences ,Medicine ,respiratory tract diseases - Abstract
Objective: Malignant pleural mesothelioma (MPM) is a rare neoplastic disorder arising from the mesothelial or sub-mesothelial cells and is associated with asbestos exposure. Its incidence is expected to increase in the next few years. The optimal combination of therapy modalities is not yet established,[for full text, please go to the a.m. URL], Gemeinsame Jahrestagung der Deutschen, Österreichischen und Schweizerischen Gesellschaft für Thoraxchirurgie
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- 2013
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4. Die 30- und 90-Tage Mortalität nach anatomischen Lungenresektionen
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Frick, AE, primary, Frese, S, additional, Graff, M, additional, Klemm, W, additional, and Leschber, G, additional
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- 2015
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5. Korrelation der Komplikationsrate mit dem Resektionsausmaß bei Tracheateilresektionen
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Frick, AE, primary, Frese, S, additional, Graff, M, additional, Klemm, W, additional, and Leschber, G, additional
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- 2014
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6. Simultaneous occurrence of a malignant mesothelioma in the chest wall and in the umbilicus - or metastatic invasion of one another? A case report
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Frick, AE, Stubenberger, E, Müller, MR, Hochmaier, M, Watzka, SB, Frick, AE, Stubenberger, E, Müller, MR, Hochmaier, M, and Watzka, SB
- Published
- 2013
7. Cortactin expression and the prognosis of malignant pleural mesothelioma
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Frick, AE, Jank, BJ, Posch, F, Stubenberger, E, Hochmair, M, Müller, MR, Watzka, SB, Brandau, S, Tötsch, M, Frick, AE, Jank, BJ, Posch, F, Stubenberger, E, Hochmair, M, Müller, MR, Watzka, SB, Brandau, S, and Tötsch, M
- Published
- 2013
8. A novel experimental porcine model to assess the impact of differential pulmonary blood flow on ischemia-reperfusion injury after unilateral lung transplantation
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Berta Saez-Gimenez, Michaela Orlitová, Stijn E. Verleden, Sofie Ordies, Arno Vanstapel, Bart M. Vanaudenaerde, Robin Vos, Dirk Van Raemdonck, Geert Verleden, Anna E. Frick, Arne Neyrinck, Sandra Claes, Tobias Heigl, Dominique Schols, J. Kaes, Institut Català de la Salut, [Frick AE, Orlitová M, Ordies S] Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium. [Vanstapel A] BREATHE, Department of Chronic Diseases, Metabolism and Ageing (Chrometa), Leuven Lung Transplant Unit, KU Leuven, Leuven, Belgium. [Claes S, Schols D] Laboratory of Virology and Chemotherapy, Department of Microbiology and Immunology, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium. [Saez-Gimenez B] BREATHE, Department of Chronic Diseases, Metabolism and Ageing (Chrometa), Leuven Lung Transplant Unit, KU Leuven, Leuven, Belgium. Unitat de Trasplantament Pulmonar, Vall d’Hebron Hospital Universitari, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus
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Porcine left lung transplantation ,medicine.medical_specialty ,medicine.medical_treatment ,Ischemia ,Primary Graft Dysfunction ,030204 cardiovascular system & hematology ,Critical Care and Intensive Care Medicine ,Circulatory and Respiratory Physiological Phenomena::Cardiovascular Physiological Phenomena::Blood Circulation::Pulmonary Circulation [PHENOMENA AND PROCESSES] ,03 medical and health sciences ,0302 clinical medicine ,fenómenos fisiológicos respiratorios y circulatorios::fenómenos fisiológicos cardiovasculares::circulación sanguínea::circulación pulmonar [FENÓMENOS Y PROCESOS] ,Internal medicine ,medicine.artery ,afecciones patológicas, signos y síntomas::procesos patológicos::complicaciones posoperatorias::daño por reperfusión [ENFERMEDADES] ,Eukaryota::animales [ORGANISMOS] ,medicine ,Lung transplantation ,Pulmonary vascular resistance ,Experimentació animal ,Research Articles ,Pathological Conditions, Signs and Symptoms::Pathologic Processes::Postoperative Complications::Reperfusion Injury [DISEASES] ,Lung ,business.industry ,lcsh:Medical emergencies. Critical care. Intensive care. First aid ,Primary graft dysfunction ,Circulació pulmonar ,lcsh:RC86-88.9 ,Reperfusió miocardíaca ,respiratory system ,medicine.disease ,Right pulmonary artery ,Eukaryota::Animals [ORGANISMS] ,Transplantation ,medicine.anatomical_structure ,030228 respiratory system ,Pulmonary artery ,Cardiology ,Human medicine ,business ,Reperfusion injury - Abstract
Trasplantament de pulmó esquerre porcí; Disfunció primària de l’empelt; Resistència vascular pulmonar Trasplante de pulmón izquierdo porcino; Disfunción primaria del injerto; Resistencia vascular pulmonar Porcine left lung transplantation; Primary graft dysfunction; Pulmonary vascular resistance Background Primary graft dysfunction (PGD) remains a major obstacle after lung transplantation. Ischemia–reperfusion injury is a known contributor to the development of PGD following lung transplantation. We developed a novel approach to assess the impact of increased pulmonary blood flow in a large porcine single-left lung transplantation model. Materials Twelve porcine left lung transplants were divided in two groups (n = 6, in low- (LF) and high-flow (HF) group). Donor lungs were stored for 24 h on ice, followed by left lung transplantation. In the HF group, recipient animals were observed for 6 h after reperfusion with partially clamping right pulmonary artery to achieve a higher flow (target flow 40–60% of total cardiac output) to the transplanted lung compared to the LF group, where the right pulmonary artery was not clamped. Results Survival at 6 h was 100% in both groups. Histological, functional and biological assessment did not significantly differ between both groups during the first 6 h of reperfusion. injury was also present in the right native lung and showed signs compatible with the pathophysiological hallmarks of ischemia–reperfusion injury. Conclusions Partial clamping native pulmonary artery in large animal lung transplantation setting to study the impact of low versus high pulmonary flow on the development of ischemia reperfusion is feasible. In our study, differential blood flow had no effect on IRI. However, our findings might impact future studies with extracorporeal devices and represent a specific intra-operative problem during bilateral sequential single-lung transplantation. AN is supported by the KU Leuven (C24/18/073). AV is sponsored by a fundamental research Grant from the FWO (1102020 N). BMV is funded by the KU Leuven University (C24/15/030 and C16/19/005). SEV is sponsored by a grant from the Research Fund-Flanders (FWO 12G8715N). RV is a senior clinical research fellow of the FWO-Flanders. OCS solution was kindly offered by Transmedics (Andover, MA, USA) without any influence on our study. This research did not receive any other specific grants from funding agencies in the public, commercial, or not-for-profit sectors.
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- 2021
9. The Effect of Prone Positioning After Lung Transplantation.
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Frick AE, Schiefer J, Maleczek M, Schwarz S, Benazzo A, Rath A, Kulu A, Hritcu R, Faybik P, Schaden E, Jaksch P, Tschernko E, Frommlet F, Markstaller K, and Hoetzenecker K
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- Humans, Prone Position, Male, Female, Middle Aged, Retrospective Studies, Adult, Patient Positioning methods, Pulmonary Gas Exchange physiology, Treatment Outcome, Lung Transplantation methods
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Background: Prone positioning has become a standard therapy in acute respiratory distress syndrome to improve oxygenation and decrease mortality. However, little is known about prone positioning in lung transplant recipients. This large, singe-center analysis investigated whether prone positioning improves gas exchange after lung transplantation., Methods: Clinical data of 583 patients were analyzed. Prone position was considered in case of impaired gas exchange Pao
2 /fraction of oxygen in inhaled air (<250), signs of edema after lung transplantation, and/or evidence of reperfusion injury. Patients with hemodynamic instability or active bleeding were not proned. Impact of prone positioning (n = 165) on gas exchange, early outcome and survival were determined and compared with patients in supine positioning (n = 418)., Results: Patients in prone position were younger, more likely to have interstitial lung disease, and had a higher lung allocation score. Patients were proned for a median of 19 hours (interquartile range,15-26) hours). They had significantly lower Pao2 /fraction of oxygen in inhaled air (227 ± 96 vs 303 ± 127 mm Hg, P = .004), and lower lung compliance (24.8 ± 9.1 mL/mbar vs 29.8 ± 9.7 mL/mbar, P < .001) immediately after lung transplantation. Both values significantly improved after prone positioning for 24 hours (Pao2 /fraction of oxygen ratio: 331 ± 91 mm Hg; lung compliance: 31.7 ± 20.2 mL/mbar). Survival at 90 days was similar between the 2 groups (93% vs 96%, P = .105)., Conclusions: Prone positioning led to a significant improvement in lung compliance and oxygenation after lung transplantation. Prospective studies are needed to confirm the benefit of prone positioning in lung transplantation., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)- Published
- 2024
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10. Computed tomography-based machine learning for donor lung screening before transplantation.
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Ram S, Verleden SE, Kumar M, Bell AJ, Pal R, Ordies S, Vanstapel A, Dubbeldam A, Vos R, Galban S, Ceulemans LJ, Frick AE, Van Raemdonck DE, Verschakelen J, Vanaudenaerde BM, Verleden GM, Lama VN, Neyrinck AP, and Galban CJ
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- Humans, Lung diagnostic imaging, Machine Learning, Prospective Studies, Tomography, X-Ray Computed, Clinical Trials as Topic, Lung Transplantation, Tissue Donors
- Abstract
Background: Assessment and selection of donor lungs remain largely subjective and experience based. Criteria to accept or decline lungs are poorly standardized and are not compliant with the current donor pool. Using ex vivo computed tomography (CT) images, we investigated the use of a CT-based machine learning algorithm for screening donor lungs before transplantation., Methods: Clinical measures and ex situ CT scans were collected from 100 cases as part of a prospective clinical trial. Following procurement, donor lungs were inflated, placed on ice according to routine clinical practice, and imaged using a clinical CT scanner before transplantation while stored in the icebox. We trained and tested a supervised machine learning method called dictionary learning, which uses CT scans and learns specific image patterns and features pertaining to each class for a classification task. The results were evaluated with donor and recipient clinical measures., Results: Of the 100 lung pairs donated, 70 were considered acceptable for transplantation (based on standard clinical assessment) before CT screening and were consequently implanted. The remaining 30 pairs were screened but not transplanted. Our machine learning algorithm was able to detect pulmonary abnormalities on the CT scans. Among the patients who received donor lungs, our algorithm identified recipients who had extended stays in the intensive care unit and were at 19 times higher risk of developing chronic lung allograft dysfunction within 2 years posttransplant., Conclusions: We have created a strategy to ex vivo screen donor lungs using a CT-based machine learning algorithm. As the use of suboptimal donor lungs rises, it is important to have in place objective techniques that will assist physicians in accurately screening donor lungs to identify recipients most at risk of posttransplant complications., (Copyright © 2023 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.)
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- 2024
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11. The hemodynamic interplay between pulmonary ischemia-reperfusion injury and right ventricular function in lung transplantation: a translational porcine model.
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Orlitová M, Verbelen T, Frick AE, Vanstapel A, Van Beersel D, Ordies S, Van Slambrouck J, Kaes J, Jin X, Coudyzer W, Verleden SE, Verleden GM, Vanaudenaerde BM, Van Raemdonck DE, Vos R, Ceulemans LJ, Claus P, and Neyrinck AP
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- Swine, Animals, Ventricular Function, Right, Troponin T, Lung, Hemodynamics physiology, Lung Injury, Lung Transplantation, Reperfusion Injury, Heart Failure, Ventricular Dysfunction, Right
- Abstract
Lung transplantation (LTx) is a challenging procedure. Following the process of ischemia-reperfusion injury, the transplanted pulmonary graft might become severely damaged, resulting in primary graft dysfunction. In addition, during the intraoperative window, the right ventricle (RV) is at risk of acute failure. The interaction of right ventricular function with lung injury is, however, poorly understood. We aimed to address this interaction in a translational porcine model of pulmonary ischemia-reperfusion injury. Advanced pulmonary and hemodynamic assessment was used, including right ventricular pressure-volume loop analysis. The acute model was based on clamping and unclamping of the left lung hilus, respecting the different hemodynamic phases of a clinical lung transplantation. We found that forcing entire right ventricular cardiac output through a lung suffering from ischemia-reperfusion injury increased afterload (pulmonary vascular resistance from baseline to end experiment P < 0.0001) and induced right ventricular failure (RVF) in 5/9 animals. Notably, we identified different compensation patterns in failing versus nonfailing ventricles (arterial elastance P = 0.0008; stroke volume P < 0.0001). Furthermore, increased vascular pressure and flow produced by the right ventricle resulted in higher pulmonary injury, as measured by ex vivo CT density (correlation: pressure r = 0.8; flow r = 0.85). Finally, RV ischemia as measured by troponin-T was negatively correlated with pulmonary injury ( r = -0.76); however, troponin-T values did not determine RVF in all animals. In conclusion, we demonstrate a delicate balance between development of pulmonary ischemia-reperfusion injury and right ventricular function during lung transplantation. Furthermore, we provide a physiological basis for potential benefit of extracorporeal life support technology. NEW & NOTEWORTHY In contrast to the abundant literature of mechanical pulmonary artery clamping to increase right ventricular afterload, we developed a model adding a biological factor of pulmonary ischemia-reperfusion injury. We did not only focus on the right ventricular behavior, but also on the interaction with the injured lung. We are the first to describe this interaction while addressing the hemodynamic intraoperative phases of clinical lung transplantation.
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- 2023
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12. CT-based Machine Learning for Donor Lung Screening Prior to Transplantation.
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Ram S, Verleden SE, Kumar M, Bell AJ, Pal R, Ordies S, Vanstapel A, Dubbeldam A, Vos R, Galban S, Ceulemans LJ, Frick AE, Van Raemdonck DE, Verschakelen J, Vanaudenaerde BM, Verleden GM, Lama VN, Neyrinck AP, and Galban CJ
- Abstract
Background: Assessment and selection of donor lungs remains largely subjective and experience based. Criteria to accept or decline lungs are poorly standardized and are not compliant with the current donor pool. Using ex vivo CT images, we investigated the use of a CT-based machine learning algorithm for screening donor lungs prior to transplantation., Methods: Clinical measures and ex-situ CT scans were collected from 100 cases as part of a prospective clinical trial. Following procurement, donor lungs were inflated, placed on ice according to routine clinical practice, and imaged using a clinical CT scanner prior to transplantation while stored in the icebox. We trained and tested a supervised machine learning method called dictionary learning , which uses CT scans and learns specific image patterns and features pertaining to each class for a classification task. The results were evaluated with donor and recipient clinical measures., Results: Of the 100 lung pairs donated, 70 were considered acceptable for transplantation (based on standard clinical assessment) prior to CT screening and were consequently implanted. The remaining 30 pairs were screened but not transplanted. Our machine learning algorithm was able to detect pulmonary abnormalities on the CT scans. Among the patients who received donor lungs, our algorithm identified recipients who had extended stays in the ICU and were at 19 times higher risk of developing CLAD within 2 years post-transplant., Conclusions: We have created a strategy to ex vivo screen donor lungs using a CT-based machine learning algorithm. As the use of suboptimal donor lungs rises, it is important to have in place objective techniques that will assist physicians in accurately screening donor lungs to identify recipients most at risk of post-transplant complications.
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- 2023
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13. Can we attenuate ischaemia-reperfusion injury of allografts in a porcine left lung transplant models by adsorption of cytokines?
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Frick AE, Orlitová M, Bleeser T, Vanstapel A, Claes S, Schols D, Mathyssen C, Ceulemans LJ, Vos R, Verleden GM, Vanaudenaerde BM, Verleden SE, Van Raemdonck DE, and Neyrinck AP
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- Swine, Animals, Cytokines, Adsorption, Lung pathology, Allografts, Gases, Lung Transplantation, Reperfusion Injury
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Objectives: Primary graft dysfunction resulting from ischaemia-reperfusion injury remains a major obstacle after lung transplantation (LTx) and is associated with morbidity and mortality. Continuous release of inflammatory cytokines, due to the process of ischaemia and reperfusion, triggers a complex cascade of apoptosis and necrosis resulting in graft dysfunction. Previous studies demonstrated successful graft improvement by cytokine filtration during ex vivo lung perfusion. We hypothesize that plasma cytokine filtration with CytoSorb® during in vivo graft perfusion immediately after implantation may attenuate ischaemia-reperfusion injury after left LTx in a porcine model., Methods: Left porcine LTx was performed with allografts preserved for 24 h at 4°C. In the treatment group [T] (n = 7), a veno-venous shunt was created to insert the cytokine filter (CytoSorbents, Berlin, Germany). In the sham group [S] (n = 4), the shunt was created without the filter. Haemodynamic parameters, lung mechanics, blood gases and plasma cytokines were assessed during 6 h in vivo reperfusion., Results: During 6 h of reperfusion, significant differences in plasma pro-inflammatory cytokine [interferon (IFN)-α, IFN-γ and interleukin (IL)-6] concentrations were observed between [T] and [S], but surprisingly with higher plasma levels in the [T] group. Plasma concentrations of other pro-inflammatory cytokines (IL-1β, IL-12p40, IL-4, IL-6, IL-8, IFN-α, IFN-γ and tumour necrosis factor-α) and anti-inflammatory cytokines (IL-10) did not find any evidence for a difference. Furthermore, our study failed to show meaningful difference in haemodynamics and blood gases. Also, no statistically significant differences were found between [T] and [S] in biopsies and wet-to-dry ratio at the end of the experiment., Conclusions: In our porcine left LTx model cytokine filtration did not achieve the intended effect. This is in contrast to previous studies with CytoSorb use during ex vivo lung perfusion as a surrogate LTx model. Our findings might highlight the fact that the theoretical benefit of inserting an additional cytokine adsorber to improve graft function in clinical practice should be critically evaluated with further studies., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
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- 2022
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14. Effect of mode of intraoperative support on primary graft dysfunction after lung transplant.
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Loor G, Huddleston S, Hartwig M, Bottiger B, Daoud D, Wei Q, Zhang Q, Ius F, Warnecke G, Villavicencio MA, Tirabassi B, Machuca TN, Van Raemdonck D, Frick AE, Neyrinck A, Toyoda Y, Kashem MA, Landeweer M, and Chandrashekaran S
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- Cardiopulmonary Bypass adverse effects, Humans, Retrospective Studies, Transplant Recipients, Treatment Outcome, Extracorporeal Membrane Oxygenation adverse effects, Extracorporeal Membrane Oxygenation methods, Lung Transplantation adverse effects, Lung Transplantation methods, Primary Graft Dysfunction diagnosis, Primary Graft Dysfunction etiology, Primary Graft Dysfunction therapy
- Abstract
Objective: To clarify the relationship between the use of extracorporeal life support during lung transplantation and severe primary graft dysfunction (PGD), we developed and analyzed a novel multicenter international registry., Methods: The Extracorporeal Life Support in Lung Transplantation Registry includes double-lung transplants performed at 8 high-volume centers (>40/year). Multiorgan transplants were excluded. We defined severe PGD as grade 3 PGD (PGD3) observed 48 or 72 hours after reperfusion. Modes of support were no extracorporeal life support (off-pump), extracorporeal membrane oxygenation (ECMO), and cardiopulmonary bypass (CPB). To assess the association between mode of support and PGD3, we adjusted for demographic and intraoperative factors with a stepwise, mixed selection, multivariable regression model, ending with 10 covariates in the final model., Results: We analyzed 852 transplants performed between January 2016 and March 2020: 422 (50%) off-pump, 273 (32%) ECMO, and 157 (18%) CPB cases. PGD3 rates at time point 48-72 were 12.1% (51 out of 422) for off-pump, 28.9% for ECMO (79 out of 273), and 42.7% (67 out of 157) for CPB. The adjusted model resulted in the following risk profile for PGD3: CPB versus ECMO odds ratio, 1.89 (95% CI, 1.05-3.41; P = .033), CPB versus off-pump odds ratio, 4.24 (95% CI, 2.24-8.04; P < .001), and ECMO versus off-pump odds ratio, 2.24 (95% CI, 1.38-3.65; P = .001)., Conclusions: Venoarterial ECMO is increasingly used at high-volume centers to support complex transplant recipients during double-lung transplantation. This practice is associated with more risk of PGD3 than off-pump transplantation but less risk than CPB. When extracorporeal life support is required during lung transplantation, ECMO may be the preferable approach when feasible., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)
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- 2022
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15. Difficulties in the differential diagnosis of large solitary pulmonary cysts.
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Frick AE, Ankersmit HJ, Simonitsch-Klupp I, and Hoetzenecker K
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- Diagnosis, Differential, Humans, Lung pathology, Cystic Adenomatoid Malformation of Lung, Congenital diagnosis, Cysts diagnostic imaging, Cysts surgery, Lung Diseases diagnosis, Lung Neoplasms diagnostic imaging, Lung Neoplasms surgery
- Abstract
Large solitary cystic lesions are a rare finding, and their differential diagnosis includes cystic airspaces associated with lung cancer, congenital pulmonary airway malformations and pneumatoceles. Here, we report 3 consecutive patients who presented with a large solitary pulmonary cyst on chest computed tomography. All underwent surgical resection, and the histopathological findings were different in all 3 cases. In one patient, a very rare finding of squamous cell carcinoma arising from the cystic lesion in the left lower lobe was confirmed. Therefore, in carefully selected cases, pulmonary cysts should be resected based on the potential risk for recurrent infection and the development of malignancy., (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.)
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- 2022
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16. Commentary: A journey of a thousand miles begins with a single step.
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Frick AE and Hoetzenecker K
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- 2022
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17. Functional outcome after single-stage laryngotracheal reconstruction with rib cartilage grafting.
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Schweiger T, Roesner I, de Faria Soares Rodrigues I, Evermann M, Frick AE, Denk-Linnert DM, Klepetko W, and Hoetzenecker K
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- Adult, Austria epidemiology, Deglutition, Female, Humans, Laryngoscopy methods, Male, Recovery of Function, Ribs, Spirometry methods, Treatment Outcome, Voice Quality, Cartilage transplantation, Laryngoplasty adverse effects, Laryngoplasty methods, Laryngostenosis diagnosis, Laryngostenosis epidemiology, Laryngostenosis physiopathology, Laryngostenosis surgery, Postoperative Complications diagnosis, Postoperative Complications epidemiology, Plastic Surgery Procedures adverse effects, Plastic Surgery Procedures methods, Tissue Transplantation methods, Tracheal Stenosis diagnosis, Tracheal Stenosis epidemiology, Tracheal Stenosis physiopathology, Tracheal Stenosis surgery
- Abstract
Objective: Single-stage laryngotracheal reconstruction (SSLTR) provides a definite surgical treatment for patients with complex glotto-subglottic stenosis. To date, the influence of SSLTR on the functional outcome after surgery has not been analyzed., Methods: A retrospective analysis of all patients receiving a SSLTR between November 2012 and October 2019 was performed. Preoperatively and 3 months postoperatively, patients received a full functional evaluation, including spirometry; voice measurements (eg, fundamental frequency; dynamic range, singing voice range, and perceptual voice evaluation using the Roughness-Breathiness-Hoarseness [RBH] score, and fiberoptic endoscopic evaluation of swallowing [FEES])., Results: A total of 15 patients with a mean age of 45 ± 17 years underwent SSTLR. Two (13%) patients were men and 13 (87%) were women. The majority of patients (67%) had undergone previous surgical or endoscopic treatment attempts that had failed. At the 3-month follow-up visit, none of the patients had signs of penetration or aspiration in their swallowing examination. Voice measurements revealed a significantly lower fundamental voice frequency (201.0 Hz vs 155.5 Hz; P = .006), whereas voice range (19.1 semitones vs 14.9 semitones; P = .200) and dynamic range (52.5 dB vs 53.0 dB; P = .777) was hardly affected. The median RBH score changed from R1 B0 H1 to R2 B1 H2. In spirometry, breathing capacity increased significantly (peak expiratory flow, 44% vs 87% [P < .001] and mean expiratory flow at 75% of vital capacity, 48% vs 90% [P < .001]). During a median follow-up of 32.5 months (range, 7-88 months), none of the patients developed re-stenosis., Conclusions: For complex glotto-subglottic stenoses, durable long-term airway patency together with reasonable voice quality and normal deglutition can be achieved by SSLTR., (Copyright © 2020. Published by Elsevier Inc.)
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- 2022
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18. Lung transplantation for acute respiratory distress syndrome: A multicenter experience.
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Frick AE, Gan CT, Vos R, Schwarz S, Kraft F, Kifjak D, Neyrinck AP, Van Raemdonck DE, Klepetko W, Jaksch P, Verschuuren EAM, and Hoetzenecker K
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- Humans, Length of Stay, Lung, Respiration, Artificial, Lung Transplantation, Respiratory Distress Syndrome
- Abstract
Acute respiratory distress syndrome (ARDS) is a rapidly progressive lung disease with a high mortality rate. Although lung transplantation (LTx) is a well-established treatment for a variety of chronic pulmonary diseases, LTx for acute lung failure (due to ARDS) remains controversial. We reviewed posttransplant outcome of ARDS patients from three high-volume European transplant centers. Demographics and clinical data were collected and analyzed. Viral infection was the main reason for ARDS (n = 7/13, 53.8%). All patients were admitted to ICU and required mechanical ventilation, 11/13 were supported with ECMO at the time of listing. They were granted a median LAS of 76 (IQR 50-85) and waited for a median of 3 days (IQR 1.5-14). Postoperatively, median length of mechanical ventilation was 33 days (IQR 17-52.5), median length of ICU and hospital stay were 39 days (IQR 19.5-58.5) and 54 days (IQR 43.5-127). Prolongation of peripheral postoperative ECMO was required in 7/13 (53.8%) patients with a median duration of 2 days (IQR 2-7). 30-day mortality was 7.7%, 1 and 5-year survival rates were calculated as 71.6% and 54.2%, respectively. Given the lack of alternative treatment options, the herein presented results support the concept of offering live-saving LTx to carefully selected ARDS patients., (© 2021 The Authors. American Journal of Transplantation published by Wiley Periodicals LLC on behalf of The American Society of Transplantation and the American Society of Transplant Surgeons.)
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- 2022
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19. Minimally invasive carinal reconstruction-is less really more?
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Frick AE and Hoetzenecker K
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Competing Interests: Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at https://dx.doi.org/10.21037/tlcr-21-759). The authors have no conflicts of interest to declare.
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- 2021
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20. Laryngotracheal resection can be performed safely without a guardian Chin stitch-a single-centre experience including 165 consecutive patients.
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Schweiger T, Evermann M, Roesner I, Frick AE, Denk-Linnert DM, Klepetko W, and Hoetzenecker K
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- Anastomosis, Surgical adverse effects, Chin, Humans, Postoperative Complications epidemiology, Retrospective Studies, Trachea surgery, Treatment Outcome, Laryngostenosis, Tracheal Stenosis
- Abstract
Objectives: A tension-free anastomosis is crucial to minimize the risk of airway complications after laryngotracheal surgery. The 'guardian' chin stitch is placed to prevent hyperextension of the neck in the early postoperative period. This manoeuvre was introduced early in tracheal surgery and is now routinely performed by many airway surgeons. However, the evidence for or against is sparse., Methods: We performed a retrospective analysis of all adult patients receiving a (laryngo-)tracheal resection at our department from October 2011 to December 2019. According to our institutional standard, none of the patients received a chin stitch. Instead, a head cradle was used to obtain anteflexion of the neck during the first 3 days and patients were instructed to avoid hyperextension of the neck during the hospital stay. The postoperative outcome and the rate of anastomotic complications were analysed., Results: A total of 165 consecutive patients were included in this study. Median age at surgery was 53 years (18-80). Seventy-four patients received a tracheal resection, 24 a cricotracheal resection, 52 an extended cricotracheal resection including dorsal mucosectomy and 15 a single-stage laryngotracheal reconstruction. The median resection length was 25 mm (range 10-55 mm). One hundred and sixty-two out of 165 (98.2%) patients had an unremarkable postoperative course. One patient (0.6%) had partial anastomotic rupture after a traumatic reintubation, which required revision surgery and re-anastomosis. Two patients (1.2%) after previous radiation therapy (>60 Gy) developed a partial necrosis of the anastomosis, resulting in prolonged airleak and fistulation. At follow-up, bronchoscopy 3 months after surgery, 92.7% (127/137) of the patients had a proper anastomosis, 6.6% (9/137) had minor granuloma formations at the site of the anastomosis, which were all treated successfully by endoscopic removal. One patient received dilatation for restenosis (0.7%)., Conclusions: After sufficient mobilization of the central airways, postoperative anteflexion of the neck supported by a head cradle is sufficient to prevent excessive anastomotic tension and dehiscence. Considering the risk for severe neurological complications associated with the chin stitch, the routine use of this manoeuvre in laryngotracheal surgery should not be recommended., (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
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- 2021
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21. Mobility during and after training: autobiography and advice to early career colleagues.
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Torres C and Frick AE
- Abstract
Mobility programs can be a valuable enhancement to medical formation and career, either during or after training as part of an internship or as a fellowship. In the case of surgery, the opportunity to visit departments who offer a broader range of operations than the home institution, learn new clinical and surgical techniques are unique possibilities to expand surgical and clinical daily routine practice but also to meet colleagues and exchange experiences for future collaboration and networking., Competing Interests: Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jtd.2019.01.71). The series “Training in Pulmonary Medicine and Surgery” was commissioned by the editorial office without any funding or sponsorship. The authors have no other conflicts of interest to declare., (2021 Journal of Thoracic Disease. All rights reserved.)
- Published
- 2021
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22. A novel experimental porcine model to assess the impact of differential pulmonary blood flow on ischemia-reperfusion injury after unilateral lung transplantation.
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Frick AE, Orlitová M, Vanstapel A, Ordies S, Claes S, Schols D, Heigl T, Kaes J, Saez-Gimenez B, Vos R, Verleden GM, Vanaudenaerde B, Verleden SE, Van Raemdonck DE, and Neyrinck AP
- Abstract
Background: Primary graft dysfunction (PGD) remains a major obstacle after lung transplantation. Ischemia-reperfusion injury is a known contributor to the development of PGD following lung transplantation. We developed a novel approach to assess the impact of increased pulmonary blood flow in a large porcine single-left lung transplantation model., Materials: Twelve porcine left lung transplants were divided in two groups (n = 6, in low- (LF) and high-flow (HF) group). Donor lungs were stored for 24 h on ice, followed by left lung transplantation. In the HF group, recipient animals were observed for 6 h after reperfusion with partially clamping right pulmonary artery to achieve a higher flow (target flow 40-60% of total cardiac output) to the transplanted lung compared to the LF group, where the right pulmonary artery was not clamped., Results: Survival at 6 h was 100% in both groups. Histological, functional and biological assessment did not significantly differ between both groups during the first 6 h of reperfusion. injury was also present in the right native lung and showed signs compatible with the pathophysiological hallmarks of ischemia-reperfusion injury., Conclusions: Partial clamping native pulmonary artery in large animal lung transplantation setting to study the impact of low versus high pulmonary flow on the development of ischemia reperfusion is feasible. In our study, differential blood flow had no effect on IRI. However, our findings might impact future studies with extracorporeal devices and represent a specific intra-operative problem during bilateral sequential single-lung transplantation.
- Published
- 2021
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23. Invasive mucinous adenocarcinoma of the lung arising in a type 1 congenital pulmonary airway malformation in a 68-year-old patient: a case report.
- Author
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Frick AE, Decaluwé H, Weynand B, Proesmans M, and Van Raemdonck D
- Subjects
- Aged, Humans, Lung, Male, Adenocarcinoma, Mucinous complications, Adenocarcinoma, Mucinous diagnosis, Adenocarcinoma, Mucinous surgery, Cystic Adenomatoid Malformation of Lung, Congenital diagnosis, Cystic Adenomatoid Malformation of Lung, Congenital diagnostic imaging, Lung Neoplasms diagnosis, Lung Neoplasms surgery, Pulmonary Blastoma
- Abstract
Introduction: Congenital pulmonary airway malformation (CPAM), previously described as congenital cystic adenomatoid malformation (CCAM), is a congenital disorder of lung parenchyma. The association with the presence of a malignant transformation like rhabdomyosarcoma, pleuropulmonary blastoma, and most common invasive mucinous adenocarcinoma (IMA) is a rare development described in patients with CPAM., Patients and Methods: Here, we report the case of a 68-year-old male patient who underwent a right lower lobectomy for a mass in the right pulmonary lobe. From his clinical history, we noted a recurrent pulmonary infection of a bullous malformation in the right lower lobe treated with antibiotics., Results: The histopathological finding showed an invasive mucinous adenocarcinoma arising in a type 1 CPAM in the right lower lobe. A review of presentation, diagnosis, and treatment of this association is described in a case report., Conclusions: Surgical resection should be considered in adults with asymptomatic cysts to prevent malignant transformation. For further analysis, histopathological examination of specimen is essential for a proper diagnosis and eventually further postoperative treatment.
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- 2021
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24. Early protein expression profile in bronchoalveolar lavage fluid and clinical outcomes in primary graft dysfunction after lung transplantation.
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Frick AE, Verleden SE, Ordies S, Sacreas A, Vos R, Verleden GM, Vanaudenaerde BM, Claes S, Schols D, Van Raemdonck DE, and Neyrinck AP
- Subjects
- Bronchoalveolar Lavage Fluid, Humans, Retrospective Studies, Tissue Donors, Lung Transplantation adverse effects, Primary Graft Dysfunction diagnosis, Primary Graft Dysfunction etiology
- Abstract
Objectives: Primary graft dysfunction (PGD) remains a major post-transplant complication and is associated with increased morbidity and mortality. Mechanisms evoking PGD are not completely clear, but inflammation plays a central role. We investigated the association between PGD and inflammatory proteins present in immediate postoperative bronchoalveolar lavage., Methods: All double-lung recipients transplanted at our institution from 2002 to 2018 were included in our study. We retrospectively selected 80 consecutive lung transplant recipients with different PGD grades (n = 20 for each PGD grades 0-1 to 2-3). In bronchoalveolar lavage performed within the first 24 h after donor aortic cross-clamping following lung transplantation, concentrations of 30 cytokines, chemokines and growth factors were assessed by enzyme-linked immunosorbent assay (ELISA) and correlated with donor and recipient demographics and outcomes. For analysis, 2 groups were defined: 'mild' PGD (grade 0-1) and 'severe' PGD (grades 2-3)., Results: Significant differences between mild and severe PGD were found in 8 biomarkers [interleukin (IL)-6, IL-10, IL-13, eotaxin, granulocyte colony-stimulating factor, interferon γ, macrophage inflammatory protein 1α, surfactant protein D (SP-D); P < 0.05]. Increased IL-10 and IL-13, but none of the other proteins, were associated with short-term outcome (longer time to extubation; P = 0.005 and P < 0.0001; increased intensive care unit stay; P = 0.012 and P < 0.0001; and hospital stay; P = 0.041 and P = 0.002). There were no significant differences in donor and recipient characteristics between the groups., Conclusions: Expression profiles of key inflammatory mediators in bronchoalveolar lavage fluid differed significantly between lung transplant recipients with severe versus mild PGD and correlated with clinical outcome variables. Further research should focus on the early mechanisms leading to PGD., (© The Author(s) 2020. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
- Published
- 2020
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25. Histopathologic and radiologic assessment of nontransplanted donor lungs.
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Vanstapel A, Dubbeldam A, Weynand B, Verbeken EK, Vos R, Neyrinck AP, Vasilescu DM, Ceulemans LJ, Frick AE, Van Raemdonck DE, Verschakelen J, Vanaudenaerde BM, Verleden GM, and Verleden SE
- Subjects
- Bronchoscopy, Humans, Lung diagnostic imaging, Tissue Donors, Tomography, X-Ray Computed, Lung Transplantation adverse effects, Tissue and Organ Procurement
- Abstract
Donor organ shortage results in significant waiting list mortality. Donor lung assessment is currently based on donors' history, gas exchange, chest X-ray, bronchoscopy findings, and ultimately in situ inspection but remains subjective. We correlated histopathology and radiology in nontransplanted donor lungs with the clinical indications to decline the offered organ. Sixty-two donor lungs, not used for transplantation (2010-2019), were procured, air-inflated, frozen, scanned with computed tomography, systematically sampled, and histologically and radiologically assessed. Thirty-nine (63%) lungs were declined for allograft-related reasons. In 13/39 (33%) lungs, histology could not confirm the reason for decline, in an additional 8/39 (21%) lungs, histologic abnormalities were only considered mild. In 16/39 (41%) lungs, radiology could not confirm the reason for decline. Twenty-three (37%) donor lungs were not transplanted due to extrapulmonary causes, of which three (13%) lungs displayed severe histologic abnormalities (pneumonia, n = 2; emphysema, n = 1), in addition to mild emphysema in 9 (39%) lungs and minor bronchopneumonia in 1 (4%). Radiology revealed ground-glass opacities in 8/23 (35%) and emphysema in 4/23 (17%) lungs. Histopathologic and radiologic assessment of nontransplanted donor lungs revealed substantial discrepancy with the clinical reason for decline. Optimization of donor lung assessment is necessary to improve current organ acceptance rates., (© 2020 The American Society of Transplantation and the American Society of Transplant Surgeons.)
- Published
- 2020
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26. Training curriculum for European thoracic surgeons: a joint initiative of the European Society of Thoracic Surgeons and the European Respiratory Society.
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Massard G, Tabin N, Konge L, Frick AE, Batirel H, Brunelli A, Elia S, Huertgen M, Molins L, Papagiannopoulos K, Subotic D, van Schil P, Varela G, and van Raemdonck D
- Subjects
- Clinical Competence, Curriculum, Europe, Humans, Surgeons, Thoracic Surgery
- Abstract
Because of the differing definitions of the margins of thoracic surgery as a specialty and the variability in the training curricula among European countries, the European Society of Thoracic Surgeons formed a task force to elaborate a consensual proposal. The first step comprised creating a harmonized syllabus that was completed and published in 2018. This publication presents a proposal for a curriculum upon which the task force and the external expert reviewers have agreed. The curriculum was developed by the task force: each module and item describe the expected level of knowledge, skills and attitudes to be attained by the participants; learning opportunities, assessment tools and minimal clinical exposures have been defined as well. Competence in terms of non-technical skills has been defined for each module according to the CanMEDS (http://www.royalcollege.ca/rcsite/canmeds/canmeds-framework-e) glossary. The different modules were subsequently submitted to an internal and an external review process and re-edited accordingly before final validation. The authors hope that this document will serve as a roadmap for both thoracic surgical trainees and mentors. It should further guide continuous professional development. However, evolving scientific and technological advances are expected to modify the diagnosis and treatment of diseases and disorders in the future and hence will mandate periodical revisions of the document., (© The Author(s) 2020. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
- Published
- 2020
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27. Prone Positioning During Ex Vivo Lung Perfusion Influences Regional Edema Accumulation.
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Ordies S, Frick AE, Claes S, Schols D, Verleden SE, Van Raemdonck DE, and Neyrinck AP
- Subjects
- Allografts pathology, Allografts surgery, Animals, Biopsy, Bronchoalveolar Lavage Fluid chemistry, Cytokines analysis, Disease Models, Animal, Edema etiology, Edema pathology, Humans, Lung pathology, Lung surgery, Lung Transplantation methods, Male, Organ Preservation adverse effects, Perfusion adverse effects, Reperfusion Injury etiology, Reperfusion Injury pathology, Sus scrofa, Tissue Donors, Vascular Resistance, Edema prevention & control, Organ Preservation methods, Perfusion methods, Prone Position, Reperfusion Injury prevention & control
- Abstract
Background: Ex vivo lung perfusion (EVLP) is developed to increase the quantity and quality of suitable grafts for lung transplantation. Standardly, lungs are mounted supine with the risk of fluid accumulation in the dorsal regions. Therefore, we investigated the impact of experimental prone position on graft function during EVLP., Materials and Methods: Porcine lungs were mounted on a normothermic EVLP for 6 h in supine [S], (n = 7) or prone position [P], (n = 7). Physiology during EVLP was recorded. After EVLP, biopsies were assessed for wet-to-dry weight (W/D) ratios and pathology, broncho-alveolar lavage was measured, and the left lung was computed tomography (CT) scanned., Results: Physiological parameters were similar between both groups, despite a higher pulmonary vascular resistance in [P] (P = 0.0002). In [S], W/D ratios and CT density of dorsal areas were higher compared to ventral (P = 0.0017 and P = 0.053, respectively). In [P], W/D and CT density between ventral and dorsal regions were similar, meaning that pulmonary edema was distributed more homogeneously throughout the lung. Histology and cytokine levels in perfusate and broncho-alveolar lavage did not differ between both groups., Conclusions: Prone positioning during EVLP is feasible and leads to more homogenous distribution of interstitial fluid. Supine position resulted in more concentrated edema accumulation in lower dependent regions., (Copyright © 2019. Published by Elsevier Inc.)
- Published
- 2019
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28. Combined modality treatment for malignant pleural mesothelioma: a single-centre long-term survival analysis using extrapleural pneumonectomy.
- Author
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Frick AE, Nackaerts K, Moons J, Lievens Y, Verbeken E, Lambrecht M, Coolen J, Dooms C, Vansteenkiste J, De Leyn P, and Nafteux P
- Subjects
- Adult, Aged, Combined Modality Therapy, Disease-Free Survival, Female, Humans, Male, Mesothelioma, Malignant, Middle Aged, Retrospective Studies, Lung Neoplasms mortality, Lung Neoplasms therapy, Mesothelioma mortality, Mesothelioma therapy, Pleural Neoplasms mortality, Pleural Neoplasms therapy, Pneumonectomy methods, Pneumonectomy mortality
- Abstract
Objectives: Combined modality treatment (CMT) for malignant pleural mesothelioma (MPM) remains a matter of debate regarding the choice of surgical procedure: extrapleural pneumonectomy (EPP) or pleurectomy/decortication., Methods: We performed a prospective interventional cohort study between 2003 and 2014. All consecutive patients with any histological MPM subtype, ≤70 years old, World Health Organization performance status ≤1, medically fit for pneumonectomy and stage cT1-2cN0-2cM0 (TNM7) or lower were included. Eligibility for CMT was discussed by the multidisciplinary tumour board. Our local CMT protocol consisted of induction chemotherapy, followed by EPP and hemithoracic radiotherapy. Induction chemotherapy consisted of 3 cycles of cisplatin (75 mg/m2 day 1) and pemetrexed (500 mg/m2 day 1), each administered once every 3 weeks. If non-progressive, EPP was performed followed by hemithoracic radiotherapy (most frequently, intensity-modulated radiotherapy; dose 54 Gy/1.8 Gy ± boost). Feasibility and long-term survival analyses were performed. Overall survival and disease-free survival (DFS) were calculated from histological confirmation of a diagnosis of MPM., Results: Out of 197 patients, 97 started with CMT (79 epithelioid, 15 mixed and 3 sarcomatoid tumours, based on histological analysis). Clinical TNM was IA (n = 9)/IB (n = 8)/II (n = 57)/III (n = 23). A total of 76 patients underwent surgery (EPP: n = 56; exploratory thoracotomy: n = 20). The in-hospital mortality rate was 3.6%. Out of 56 patients who underwent surgery, 47 completed the entire CMT protocol. The intent-to-treat median and 5-year OS were 22.4 [95% confidence interval (CI) = 15.5-27.9] months and 11.2% (95% CI = 6.9-23.4). In patients who completed the CMT protocol (n = 47), these values were 33.2 (95% CI = 23.0-45.0) months and 24.2% (95% CI = 13.4-43.8). The intent-to-treat median and 5-year DFS were 15.6 (95% CI = 14.0-17.3) months and 9.9% (95% CI = 5.1-19.2), 19.8 (95% CI = 16.8-27.7) months and 17.2% (95% CI = 8.6-34.1) in those who had the full CMT. The Cox proportional hazards model showed a significantly lower DFS in positive lymph nodes (HR 2.79, 95% CI=1.35-5.78; P=0.006). In 30 (64%) patients with epithelioid type MPM without positive lymph nodes (pN0) after EPP, the 5-year DFS was 27.0% (95% CI=14.1-51.7)., Conclusions: CMT with EPP for MPM is feasible, with an acceptable surgical mortality rate, and results in a 5-year survival rate of 24%. Careful patient selection (staging and physical performance) is extremely important., (© The Author(s) 2018. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
- Published
- 2019
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29. Azithromycin and early allograft function after lung transplantation: A randomized, controlled trial.
- Author
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Van Herck A, Frick AE, Schaevers V, Vranckx A, Verbeken EK, Vanaudenaerde BM, Sacreas A, Heigl T, Neyrinck AP, Van Raemdonck D, Dupont LJ, Yserbyt J, Verleden SE, Verleden GM, and Vos R
- Subjects
- Allografts, Double-Blind Method, Female, Forced Expiratory Volume, Humans, Male, Middle Aged, Prospective Studies, Recovery of Function, Time Factors, Azithromycin therapeutic use, Lung physiology, Lung Transplantation, Primary Graft Dysfunction prevention & control
- Abstract
Background: Chronic lung allograft dysfunction (CLAD) is the single most important factor limiting long-term survival after lung transplantation (LTx). Azithromycin has been shown to improve CLAD-free and long-term survival, yet the possible impact on early lung allograft function is unclear., Methods: A prospective, randomized, double-blind, placebo-controlled trial of pre-transplant and prompt post-transplant azithromycin treatment was performed at the University Hospitals Leuven. In each arm, 34 patients, transplanted between October 2013 and October 2015, were included for analysis. Study drug was added to standard of care and was administered once before LTx (1,000 mg of azithromycin or placebo) and every other day from Day 1 until Day 31 after LTx (250 mg of azithromycin or placebo). Primary outcome was an anticipated 15% improvement of forced expiratory volume in 1 second (FEV
1 , percent predicted) during the first 3 months post-LTx. Secondary end-points included length of intubation, days on ventilator, duration of intensive care unit and hospital stay, prevalence and severity of primary graft dysfunction, acute rejection, infection, and CLAD-free and overall survival., Results: FEV1 was not significantly different between the 2 groups (p = 0.41). Patients treated with azithromycin demonstrated less airway inflammation, with lower bronchoalveolar lavage (BAL) neutrophilia and BAL interleukin-8 protein levels at Day 30 (p = 0.09 and p = 0.04, respectively) and Day 90 (p = 0.002 and p = 0.08, respectively) after LTx. Other secondary outcomes were not significantly different between placebo and azithromycin groups., Conclusions: Pre-transplant and prompt post-transplant azithromycin treatment was not able to improve early lung allograft function. However, the known anti-inflammatory properties of azithromycin were confirmed (NCT01915082)., (Copyright © 2018 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.)- Published
- 2019
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30. European questionnaire on the clinical use of video-assisted thoracoscopic surgery.
- Author
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Cao C, Frick AE, Ilonen I, McElnay P, Guerrera F, Tian DH, Lim E, and Rocco G
- Subjects
- Europe, Humans, Patient Selection, Procedures and Techniques Utilization, Surveys and Questionnaires, Carcinoma, Non-Small-Cell Lung surgery, Lung Neoplasms surgery, Pneumonectomy statistics & numerical data, Thoracic Surgery, Video-Assisted statistics & numerical data, Thoracotomy statistics & numerical data
- Abstract
Objectives: Video-assisted thoracoscopic surgery (VATS) has emerged as a safe and efficacious alternative approach to conventional thoracotomy for selected patients with non-small-cell lung cancer. The aim of the present study was to assess the current clinical practice of VATS among the European Society of Thoracic Surgeons (ESTS) members., Methods: A standardized questionnaire was sent to thoracic surgeons on the ESTS mailing list, with collection of data on demographics, use of multiportal or uniportal VATS, institutional experience with VATS procedures and proportion of operations performed by different approaches. Analysis was performed using SPSS statistical software., Results: Complete questionnaire results were collected from 100 unique institutions in 31 countries, representing data on the clinical practice of 461 board-certified thoracic surgeons. Three hundred and twenty-four of the 461 (70%) surgeons claimed to perform anatomical VATS resections, with a total estimated caseload of 9519 resections per year. Two hundred and thirty-one (50%) surgeons reported to have performed lobectomies primarily through the VATS approach. The case volume was significantly correlated to the number (P = 0.019) and proportion (P = 0.001) of surgeons who performed VATS anatomical resections. Overall, 47% of the centres performing anatomical VATS resections reported some use of uniportal approach. There was no association between the number of thoracic surgeons within an institution and the likelihood of performing uniportal VATS lobectomy., Conclusions: Compared to previous surveys, results of the present European study suggested that there is a strong trend favouring VATS for a range of thoracic procedures in the current clinical setting. However, the use of uniportal VATS is still not yet widespread. The evolving adoption of VATS in Europe should be further assessed with regard to clinical outcomes in the form of large standardized registries.
- Published
- 2018
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31. The resident's point of view in the learning curve of thymic MIS: why should I learn it?
- Author
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Frick AE, Van Veer H, Decaluwé H, Coosemans W, and Van Raemdonck D
- Abstract
Minimally invasive surgery (MIS) in thoracic surgery became quite popular during the last years. The aim of introducing and performing more MIS is to reduce surgical trauma, pain and complications in patients. Training in MIS increases operative time and thus cost in theatre but thus improves with experience. For a resident, the cases should be well selected with experienced supervision in a suitable setting with supporting staff and optimal instruments. Understanding the anatomy of the lung, using simulators, and attending workshops makes the learning curve shorter., Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare.
- Published
- 2018
- Full Text
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32. Thoracic surgery training in Europe-the perspective of a trainee.
- Author
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Frick AE and Massard G
- Abstract
Duration and content of Thoracic surgery training differs considerably across Europe, leading to unequal levels of knowledge, skills and attitudes at the time of graduation as a specialist. The European Board of Thoracic Surgery examination strives to overcome these regional differences by offering a diploma to achieve harmonization and equal qualified certification. The HERMES initiative, driven by a joint task force from European Society of Thoracic Surgeons (ESTS) and European Respiratory Society (ERS) is currently establishing a consensual syllabus and curriculum for Thoracic Surgery to standardize content of training and achieve equal levels of qualification all-over Europe. In this context, new opportunities in teaching and learning have become available and should be considered to support and encourage for beneficial development in the future. International platforms are the key for connecting with experts and other trainees and are provided by annual meetings and within the ESTS School., Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare.
- Published
- 2017
- Full Text
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